Associations between sleep disturbance and alcohol drinking: A large-scale epidemiological study of adolescents in Japan

In this study, we attempted to clarify the associations between various sleep disturbance symptoms and the frequency and amount of alcohol use among Japanese adolescents. This study was designed as a cross-sectional sampling survey. A self-administered questionnaire survey was administered to students enrolled in randomly selected junior and senior high schools throughout Japan. A total of 99,416 adolescents responded, and 98,867 questionnaires were subjected to analysis. The prevalence rates of sleep disturbance in the 30 days preceding the day of the survey were as follows: subjectively insufficient sleep (SIS) (boys: 37.6%, girls: 38.7%); short sleep duration (SSD) with less than 6 h of sleep (boys: 28.0%, girls: 33.0%); difficulty initiating sleep (DIS) (boys: 12.5%, girls: 14.1%); difficulty maintaining sleep (DMS) (boys: 10.1%, girls: 10.9%); and early morning awakening (EMA) (boys: 5.1%, girls: 5.0%). Adolescents reporting one or more symptoms of DIS, DMS, and EMA were classified as having insomnia, and its prevalence was 21.5%. The prevalence of each symptom of sleep disturbance increased significantly with the number of days on which alcohol was consumed in the previous 30 days and the amount of alcohol consumed per drinking session (p < 0.01). Multiple logistic regression analyses showed that the adjusted odds ratio (AOR) for each symptom of sleep disturbance, except SIS and EMA, tended to increase with the number of days on which alcohol was consumed and the amount of alcohol consumed per drinking session. The prevalence of sleep disturbance is particularly high among adolescents drinking alcohol. The risk of having each symptom of sleep disturbance, except SIS and EMA, increases with the number of days on which alcohol was consumed and the amount of alcohol consumed per drinking session. These findings reconfirm the need to eliminate underage drinking to ensure good sleep among adolescents.     

广州市中小学生精神活性物质滥用现状研究

[目的]了解广州市中小学生精神活性物质滥用的现状．为进行学生健康教育提供参考。[方法]分层随机整群抽取广州市8所小学4-6年级，9所中学初一至高三的8222名学生进行问卷调查。[结果]有23.6%的学生尝试过吸烟,有7.5%的学生是经常性吸烟,有53.2%的学生尝试过饮酒,有过其他药物滥用行为的学生的比例高达7.1%,中学生发生吸烟,饮酒和药物滥用的主要原因是＂好奇＂和＂受周围人影响＂（分别占87.5%,78.7%和87.0%）烟酒及其他药物滥用者中感到身体受到了损害的分别有20.4%,12.3%和52.8%,学生曾因用药后伤人中以喝酒后伤人的学生比例最多占5.2%.[结论]中小学生中发生吸烟,喝酒和其他精神药物滥用的情况已不容忽视,提倡在中小学生中开展个性化健康教育来预防和控制精神活性物质滥用行为.     

农村中小学生网络使用情况调查

目的了解我市农村青少年学生网络使用情况。方法采取分层整群抽样,抽取小学、初中、高中24个班共1 285人,组织学生自填问卷(调查表)。结果农村中小学5年级以上学生上网率为40.1%,随年级的升高而增高,男生明显高于女生,上网地点以在网吧上网为主(72.4%)。结论社会、家庭、学校相互配合,改善教学质量,丰富学生课余生活,释放学生疲惫与压力,对其网络使用加以引导及监督,最大限度防止中小学生迷恋游戏机、网络的现象发生。     

广州市学生网络成瘾与睡眠不足现状及关系

目的 了解广州市学生网络成瘾及睡眠不足现状及其关系,为学生网络成瘾和睡眠不足防控政策的制定提供理论依据。方法 采取分层整群随机抽样法,使用《学生健康状况及影响因素调查表》对广州市11个区的大、中、小学生进行网络成瘾及睡眠时间调查,采用单、多因素分析方法对睡眠不足与网络成瘾相关性进行分析。结果 本研究共对广州市大、中、小学生19 716人进行分析,男生9 811人,女生9 905人;城区17 400人,郊区2 316人;小学5 215人,初中5 476人,高中5 188人,职高2 068人,大学1 769人。93.4%的学生过去1周上过网,16.2%的学生过去1周每天上网≥4 h。网络成瘾报告率为4.0%,女生（4.7%）高于男生（3.4%）,郊区（4.5%）高于城区（2.3%）,小学、初中、高中、职高和大学生分别为0.7%、3.7%、3.4%、6.0%和14.5%,郊区小学、初中、高中生网络成瘾报告率均高于城区同学段学生,郊区初中女生（7.7%）最高,差异均有统计学意义（P <0.05或P <0.01）。睡眠不足发生率为71.2%,控制性别、学段、地区等因素后,二分类logistic回归分析结果显示网络成瘾行为者发生睡眠不足的风险是非网络成瘾行为者的1.579倍。结论 广州市学生网络成瘾报告率与睡眠不足发生率均较高,郊区学生、职高生和大学生网络成瘾行为现象尤为严重,中、小学生睡眠不足问题突出,网络成瘾可增加睡眠不足的风险。应针对重点人群,制定科学可行的干预策略及措施。     

北京市部分中学生艾滋病知识态度和技能行为现状

目的了解目前中学开展预防艾滋病健康教育的现状,为探讨更有效的教学方式和方法提供依据。方法2005年10-11月,对北京市6所初中、4所高中的1489名学生进行问卷调查。结果艾滋病的传播途径回答正确率为85.3%,艾滋病的非传播途径回答正确率为28.1%。联合国大会艾滋病特别会议制定的5项核心指标全部回答正确率为13.1%,高中生高于初中生,男生高于女生。对相关态度题目赋值后,高中生的正向态度得分明显高于初中生,女生高于男生。技能和行为方面,高中生得分高于初中生,女生得分高于男生。70.6%的学生表示愿意在学校开展预防艾滋病健康教育。结论中学生预防艾滋病知识水平有待提高,建议学校应以行为改变为最终目标,开展以生活技能为基础的预防艾滋病健康教育。     

2007年新乡市城区部分中小学生营养状况调查

[目的]了解中小学生营养状况,为采取干预措施提供科学依据。[方法]2007年9月,在新乡市城区抽取4所中小学校的1200名在校学生进行营养状况调查,根据身高体重值进行评价。[结果]调查1 200名中、小学生,营养不良率为18.25%,超重率为9.83%,肥胖率为10.17%。营养不良率高中生高于初中生、小学生,女生高于男生(P<0.01);超重率、肥胖率小学生高于高中生,男生高于女生(P<0.01)。[结论]新乡市城区中小学生营养不良率有降低趋势,超重、肥胖率有升高趋势。     

广州市越秀区1139名青少年健康相关行为调查

目的了解广州市青少年的主要健康相关行为,为青少年健康教育工作及制定干预措施提供依据。方法采取整群随机分层抽样法,抽取广州市越秀区2所初中、3所高中和1所大学校共1 139名学生,对饮食、运动与吸烟饮酒情况进行问卷调查。结果广州市青少年健康危险行为主要有缺乏体育锻炼、喝酒、吸烟。初中生喝饮料、吃西式快餐、喝牛奶、吃早餐比例分别为26.7%、9.8%、54.9%、81.6%,高中生分别为18.0%、4.9%、41.2%、91.3%,均高于大学生(8.0%、3.4%、18.8%、64.2%);男生(7.1%)吃西式快餐比例高于女生(4.6%),而男生(75.0%)吃早餐比例低于女生(85.9%)。随着年龄的增大,1周内青少年每天活动至少1 h的天数相对减少;男生每周活动时间比女生长。结论缺乏体育锻炼、吸烟和喝酒普遍存在于广州市青少年当中,有必要采取干预措施,广泛开展各种健康促进活动。     

School factors and smoking prevalence among high school students in Japan

The purpose of this study was to analyze the relationship between student smoking prevalence by school and school factors. Junior and senior high schools were selected from throughout Japan using a simple random sampling. One hundred junior high schools and 50 senior high schools were randomly selected. Of these 70 junior high schools (70%) and 33 senior high schools (66%) responded to this survey. Self-administered anonymous questionnaires were completed by all enrolled students in each school. The principal of each school completed a school questionnaire about school factors. The smoking rate of male teachers was significantly related to the student smoking rate in junior high schools. This factor was still associated with the student smoking rate after adjusting for family smoking status. Surprisingly, the smoking rates for junior high school boys in schools with a school policy against teachers smoking were higher than those of schools without one. The dropout rate and the proportion of students who went on to college were significantly related to the smoking rates among senior high school students of both sexes. The regular-smoker rate of boys in schools with health education on smoking was more likely to be low. It is important to take account of school factors in designing smoking control programs for junior and senior high schools.     

中国5省市中学生危险行为调查报告（三）——吸烟、饮酒和成瘾类药物滥用状况

目的：了解中国中学生吸烟、饮酒和成瘾类药物滥用的现状。方法：1999年5－6月,选取中国北京、天津、深圳、沈阳和云南5省市的40所中学的初一和高一学生16580名,采取中学生危险行为问卷调查。结果:有36．1％的学生尝试过吸烟,有7．1％的学生是经常性吸烟,有57．8％的学生尝试过饮酒,因喝酒而受伤的学生比例占2．9％,有过药物滥用行为的学生的比例高达6．8％,高中学生发生吸烟、饮酒和药物滥用情况的比例明显高于初中学生,男生的比例明显高于女生,性别、年级之间差异有显性（P＜0．01）。结论：中学生中发生吸烟、饮酒和成瘾类药物滥用的情况已不容忽视,针对青少年不同地区、年龄、性别的特点,进行有针对性的健康教育是必要的。     

广州地区高中生饮酒模式及过量饮酒的社会经济地位影响因素

目的 分析广州市高中生饮酒模式,探讨不同社会经济地位指标与青少年过量饮酒行为的关系,为制定控制策略措施提供依据。方法 采用多阶段分层随机整群抽样方法,抽取广州市4个区高一和高二学生共3 282人,采用自填问卷进行调查。结果 75.61%的学生有饮酒经历;过去一年内,60.22%的学生曾饮酒,27.67 %曾醉酒;过去30 d内,22.75%的学生曾饮酒,7.17%曾重度饮酒。总体上,男生五种饮酒行为流行率均高于女生,差异均有统计学意义(P<0.05);采用广义混合线性模型,分析不同社会经济地位指标对青少年过量饮酒的影响。结果显示,与家庭富裕程度低、学业成就高的青少年相比,来自家庭富裕程度高、学业成就低的青少年较可能有重度饮酒及醉酒行为。结论 广州地区高中生饮酒普遍化,提示防治工作的紧迫性,应及早开展健康教育和干预工作来减少酒精的可及性和青少年的饮酒行为。     

Smoking and alcohol drinking behavior among Japanese adolescents--results from "Japan Know Your Body Study"]

The "Japan Know Your Body Study" (JKYB) is an example of collaborative activities of technology transfer carried out in Japan in several phases. The first phase is a needs assessment and data collection survey and it was administered during 1989. A survey was conducted throughout 9 prefectures in Japan with participation by 49 schools. Subjects were students in elementary, junior and senior high schools who ranged in age from 6 to 18 years. Participants, 12,892 in total, completed a survey on knowledge, attitude and behavior regarding cigarette smoking, alcohol drinking, diet, exercise and so on. The main results concerning cigarette smoking and alcohol drinking behavior were as follows: 1) The percentage of monthly male smokers rose remarkably from 8% in the third grade of junior high school to 37% in the third grade of senior high school, while that of female smokers showed a slow rise from 3% to 15%. The sex difference for smoking behavior was clear among senior high school students. 2) Smoking rates increased in proportion to the numbers of parents, siblings and friends who smoked. Above all, smoking behavior of friends was strongly related. Among senior high school students, for example, 50% of males and 46% of females who had two or more smoking friends were smokers, as compared to 5% of males and 2% of females with no smoking friends. 3) The percentage of monthly drinkers rose at a steady pace from 13% of males and 7% of females in the fifth grade of elementary schools to 59% of males and 50% of females in the third grade of senior high schools. The sex difference for alcohol drinking behavior among senior high school students, while statistically significant, was not as pronounced as that for smoking behavior. These results suggest that tobacco- and alcohol-use prevention programs should be introduced in elementary schools and those programs should include components relating to the social influences of parents, siblings and friends.     

青少年学生吸烟饮酒及其他药物使用的现状调查

目的了解青少年学生吸烟饮酒及其他药物使用的现状，为预防吸烟饮酒对青少年身体的危害提供数据。方法以菏泽市6所学校的1699名青少年学生为研究对象，采用修订的青少年危险行为调查问卷。结果51．4％的学生吸过烟，14．2％的学生近期内吸烟，8．0％的学生经常吸烟，12．8％的学生尝试过戒烟，15．5％的学生在13岁前就吸过1整支烟。76．5％的学生喝过酒，36．7％的学生近期内喝酒，27．7％的学生喝醉，37．1％的学生在13岁前饮酒。6．5％的人未经医生许可私自服用镇静安眠类药物，6．2％的人对服用过的药物有依赖。在吸烟、饮酒及其他药物使用的得分上，大学生高于高中生，高中生高于初中生。男生明显高于女生，农村学生普遍高于城市学生（P〈0．01）。结论青少年学生吸烟饮酒及其他药物使用的情况较为普遍，学校应针对青少年学生不同年龄阶段的特点，开展有针对性的健康教育，以减少吸烟饮酒对其的危害。     

2007年长春市部分中小学生生长发育及肥胖状况调查

[目的]了解长春市青少年的生长状况及肥胖现状。[方法]2007年,在长春市城乡抽取15所学校,对2112名中小学生检测身高、体重、胸围,评估肥胖状况。[结果]随着年级的增长,身高、体重、胸围均呈增长趋势,小学一年级至高中一年级上升趋势比较明显,高中一年级至高中三年级趋于平缓。体重小学一年级至高中一年级男生均高于女生,高中三年级女生高于男生’（P〈0．01）;男生身高各年龄段均高于女生（P〈0．01或〈0．05）。身高小学一年级、小学四年级、高中一年级城区均高于农村（P〈0．05）;体重高中一年级、高中三年级城区高于农村（P〈0．01）;胸围小学四年级城区高于农村,初中一年级、高中一年级农村高于城区（P〈0．01或〈0．05）。其他各项指标各组间的差异均无统计学意义（P〉0．05）调查学生的肥胖率为13．49％,随着年级的增加肥胖率逐渐升高（P〈0．01）;肥胖率男生为17．05％,女生为10．35％（P〈0．01）;城区为14．68％,农村为12．61％（P〉0．05）。[结论]长春市城乡中小学生生长发育过程中存在一些不协调现象,肥胖率呈高增长趋势。     

天津市学生网络成瘾流行病学调查

目的了解天津市区青少年学生网络成瘾流行水平和分布情况,探讨实用的判定标准。方法采用分层随机整群抽样的方法,抽取天津市区的6所中学和中专、大专、大学各1所,对8 694名学生进行问卷调查。网络成瘾评定标准：（1）过去7 d内平均每天上网≥4 h;（2）不上网时仍想网络内容;（3）不能上网时感到无聊和焦虑;（4）希望上网时间长于目前;（5）上网时间经常超出预期;（6）想不上网但无法自控;（7）因上网不能完成作业或逃学;（8）向家长、老师和同学隐瞒上网事实;（9）因上网与家长冲突;（10）上网的目的是为了摆脱困境、抑郁、无助或焦虑。至少有5项符合的判定为网络成瘾症（IAD）,有3～4项符合者判定为网络成瘾倾向（IAT）。采用2000年全国人口普查初中至大学各学习阶段的人口构成计算样本权重。结果每天平均上网2、3、4 h学生的IAD检出率差别有统计学意义（P〈0.01）,不同学习阶段学生的IAD检出率差别有统计学意义（P〈0.01）。经卡方分割检验发现,以中专生IAD检出率最高,为11.69%,初中和高中分别为5.98%和5.95%,大专和大本分别为6.74%和6.73%;IAT检出率依次为初中（8.65%）、高中（12.11%）、中专（13.96%）、大专（15.58%）、大学（16.73%）;经按学习阶段和性别加权,IAD检出率为6.90%,其中男性为9.50%,女性为4.17%;IAT检出率为11.78%,其中男性为14.43%,女性为8.96%;经济水平较好的地区的中学生IAD、IAT检出率分别为4.16%和8.27%,均低于经济水平一般和较差的地区;重点中学与非重点中学IAD、IAT检出率差别无统计学意义。结论中专学生IAD检出率最高,IAT也处于较高水平;经济水平较好地区的中学生IAD、IAT检出率均低于经济水平一般和较差的地区。     

某县城区5126名初中生高血压患病及药物治疗现状调查

目的 对中学生高血压患病及药物治疗情况进行调查分析,为儿童青少年高血压防治提供依据。方法采用整群抽样的方法抽取某县县城3所中学所有在校初中生开展调查。采用自行设计的问卷调查学生的年龄、性别、疾病史和家族史等基本情况,同时采用标准方法测量身高、体重和血压。结果 共调查5 126名在校初一至初三学生,其中男生2 711名,女生2 505名。随着学生身高和体重的增加,男生和女生的收缩压及舒张压均明显增加。男生和女生的高血压总检出率分别为4.83%和3.95%,随着年级的增加,男生和女生的高血压检出率均明显增加（χ2=11.229,P<0.001）。学生的高血压知晓率为9.13%。2级高血压患者的药物治疗率为27.27%,主要用药为卡托普利片和苯磺酸氨氯地平片。结论 该县的中学生高血压患病率与国内的相关报道基本一致;学生高血压知晓率和治疗率较低,需改善药物治疗。     

2005～2008年辽源市中小学生贫血患病状况分析

[目的]了解辽源市中小学生贫血患病情况,为制订贫血的综合防治措施提供科学依据。[方法]对2005-2008年辽源市部分中小学生Hb检测资料进行分析。[结果]中小学生贫血检出率,2005年为21.35%,2006年为13.37%,2007年为9.08%,2008年为9.25%（P〈0.01）。2005-2008年平均贫血检出率,小学生为10.26%,初中生为10.87%,高中生为25.44%;男生为16.21%,女生为6.29%（P〈0.05）。小学生、初中生、高中生的贫血检出率均逐年呈下降趋势（P〈0.01）;小学女生呈逐年下降趋势（P〈0.01）,初中男生呈下降趋势（P〈0.01）,高中男生、女生均为2007年、2008年较2005年、2006年明显下降（P〈0.01）。[结论]辽源市中小学生贫血患病率呈逐年下降趋势,贫血患病率高中生最高,女生高于男生。     

新昌县中学生艾滋病知识态度及性行为现状分析

目的：了解中学生艾滋病知识态度及性行为的现状,为制定相应的教育策略和预防措施提供科学依据。方法：采用整群随机抽样方法,随机抽取9所中学（7所初中,2所高中）17个班进行健康危险行为调查。结果：中学生对艾滋病病原体的知晓率为60．47％,男生（61．70％）高于女生（60．39％）,差异有统计学意义（Х^2=5．137,P=0．023）;高中生艾滋病知识知晓率（75．20％）高于初中生（48．01％）（Х^2=120．419,P=0．000）;知识知晓率与相关态度呈正相关关系（r=0．421,P=000）。有4．42％学生报告曾经有过性行为,男生（4．82％）高于女生（4．02％）,职业中学报告率（10．81％）〉普通高中（5．77％）〉初中学生（1.83％）;男、女生报告率都随年级增加而上升的。结论：对中学生进行科学的、适宜的艾滋病预防和性行为教育非常必要,要针对不同的人群采取相应的干预措施。     

Promoting non-smoking behavior in 13-year-old students in primary schools and high schools. A prospective, randomized intervention study with 1,956 students

1956 7th grade students of high schools and secondary modern schools in three cities with 110,000 to 180,000 inhabitants were asked about cigarette, alcohol and drug consumption using questionnaires. Subsequently 1080 of the students took part in a newly invented non-smoking curriculum which was held during 8 lessons within 4 weeks (intervention group (I)). The lessons were performed by non-smoking physicians who had passed a training programme before. 876 students served as control (C) group. 2 years later the questioning was repeated. The number of students who started smoking within the two years was significantly lower in the intervention group. In the high schools a significant effect was seen in boys (I: 13.0%, K: 22.4%; p < 0.01) and girls (I: 21.4%, K: 28.4%; p < 0.05) whereas in secondary modern schools a significant effect was seen only in boys (I: 17.4%, K: 25.2%; p < 0.05) not in girls (I: 18.0%, K: 22.0%; n.s.). First-time consumers of drugs like cannabis, marihuana and organic solvents were found less often in the intervention group among boys in high schools than in the control group (I: 14.9%; K: 23.6%; p < 0.05). No effects of the intervention were seen in girls of high schools and in students of secondary modern schools. No effects of the intervention were seen on alcohol consumption. Students who drank beer, wine or liquor several times a week were found at the same rate in the intervention and control groups. We conclude that a non-smoking intervention of 8 lessons in the 7th grade of high schools and secondary modern schools may lower the rate of first-time consumers of cigarettes but not of alcohol and drugs.     

南京市县乡中学生健康相关行为调查

目的了解南京市县乡中学生健康相关行为现状,为制定相关控制措施提供依据。方法以整群随机抽样方法,抽取南京市县乡15所中学4124名中学生,采用"中国青少年健康相关行为调查问卷"进行问卷调查。结果4124名中学生每天喝牛奶的报告率为39.2,每天吃早餐的报告率为77.0,偏食报告率为34.6,每天锻炼报告率为14.5,曾尝试吸烟的报告率为22.2,饮酒报告率为52.8,吸毒报告率为0.9,网络成瘾报告率为4.8,参与赌博报告率为20.0;30d内骑车经常或总是违规报告率为51.3,受到欺侮报告率为54.7,12个月里考虑自杀报告率为15.6,想过离家出走报告率为22.2。高中生不良饮食习惯、缺乏锻炼、尝试吸烟、饮酒、吸毒、网络成瘾、参与赌博、30d内骑车经常或总是违规、12个月里考虑自杀、想过离家出走的报告率均高于初中生(P值均<0.01)。高中男生吸烟、饮酒、吸毒、网络成瘾、参与赌博、30d内骑车经常或总是违规、受到欺侮、性行为报告率高于女生,而高中女生考虑自杀报告率高于男生(P值均<0.05)。结论南京市县乡中学生不良健康相关行为发生率较高,多种不良健康相关行为在初、高中和性别之间差异有统计学意义。     

枣庄市峄城区2004年中学生视力状况调查

[目的]了解峄城区中学生视力状况，给今后的防治工作提供依据。[方法]2004年9～11月对全区22所初、高中学生进行了调查。[结果]调查20804名学生，视力低下8351名，视力低下率40．14％。其中，初中生视力低下率35．55％，高中生视力低下率61．04％；男生视力低下率37．90％，女生视力低下率42．98％，差异有统计学意义（P〈0．01）。轻度视力低下率21．63％，中度视力低下率34．03％，重度视力低下率44．30％。城区学生视力低下率49．16％，农村学生视力低下率35．79％，差异有统计学意义（P〈0．01）。[结论]学生视力状况不容乐观，应引起高度重视。